[Evaluation of agreement between clinical and pathomorphologic diagnosis of pulmonary embolism]

Area of Science:

• Medical Diagnostics
• Pathology
• Cardiovascular Medicine

Background:

• Pulmonary embolism (PE) diagnosis is frequently inaccurate.
• High rates of false-positive and false-negative clinical diagnoses exist.
• Accurate ante-mortem diagnosis of PE remains a clinical challenge.

Purpose of the Study:

• To evaluate the accuracy of ante-mortem clinical diagnoses of PE.
• To compare clinical diagnoses with pathological findings from autopsy.
• To identify factors associated with diagnostic errors in PE.

Main Methods:

• Retrospective review of 78 autopsy cases.
• Comparison of clinical diagnoses with autopsy-confirmed pathological diagnoses.
• Analysis of misdiagnosed conditions and associated patient factors.

Main Results:

• Of 64 clinically diagnosed PE cases, 43 (67%) were confirmed by autopsy.
• 33% of clinical PE diagnoses were false-positives.
• 25% of pathological PE diagnoses (14/57) were false-negatives, meaning PE was missed clinically.
• Venous diseases were more prevalent in confirmed PE cases compared to false-positive cases.

Conclusions:

• Clinical diagnosis of PE has substantial error rates.
• Autopsy confirmation rates for clinical PE diagnoses are suboptimal.
• Further investigation into diagnostic markers and clinical features is warranted to improve PE detection.